Ticagrelor and Aspirin or Aspirin Alone after Coronary Surgery for Acute Coronary Syndrome.

Background: Patients benefit from antiplatelet therapy after coronary-artery bypass grafting (CABG) for an acute coronary syndrome. Whether the addition of ticagrelor to aspirin, as compared with aspirin alone, further reduces the risk of adverse cardiovascular outcomes is unclear.

Methods: In this open-label, registry-based, clinical trial conducted at 22 Nordic cardiothoracic surgery centers, we randomly assigned patients in a 1:1 ratio to receive either ticagrelor plus aspirin or aspirin alone for 1 year after CABG for an acute coronary syndrome.

Helicobacter pylori Screening After Acute Myocardial Infarction: The Cluster Randomized Crossover HELP-MI SWEDEHEART Trial.

Importance: Upper gastrointestinal bleeding is common after myocardial infarction.

Objective: To determine whether routine screening for Helicobacter pylori infection during hospitalization for myocardial infarction reduces bleeding events and improves clinical outcomes.

Design, Setting, And Participants: A nationwide, open-label, 2-period, 2-sequence, cluster randomized, crossover clinical trial using a clinical registry for study population definition and data collection merged with national Swedish health data registries.

An in-depth analysis of coronary computed tomography angiography segmental findings in acute spontaneous coronary artery dissection - a prospective multicenter study.

Aims: Spontaneous coronary artery dissection (SCAD), causing acute coronary syndrome (ACS), primarily in middle-aged women, is diagnosed with invasive coronary angiography (ICA). Due to the risk of dissection propagation with ICA, a non-invasive diagnostic tool is needed. We investigated coronary computed tomography angiography (CCTA) findings in acute SCAD, as well as the inter-modality agreement between CCTA and ICA.

Impact of Dapagliflozin on Cardiometabolic Outcomes After Acute Myocardial Infarction According to Baseline Glycemic Status and Body Mass Index: Subanalyses of the DAPA-MI Trial.

Background: Dapagliflozin improved cardiometabolic outcomes following myocardial infarction in patients without prior type-2 diabetes (T2DM) in the DAPA-MI (dapagliflozin in patients with myocardial infarction) trial. The effect of glycemic status and body mass index (BMI) post-myocardial infarction requires elucidation.

Methods: Participants with T2DM diagnosis, without baseline hemoglobin A1c, or not receiving any study medication, were excluded.

Nonculprit Vulnerable Plaques and Prognosis in Myocardial Infarction With Versus Without ST-Segment Elevation: A PROSPECT II Substudy.

Background: Clinical guidelines recommend different revascularization strategies for nonculprit lesions in patients with ST-segment-elevation myocardial infarction (STEMI) versus non-STEMI (NSTEMI). Whether the prevalence of untreated high-risk vulnerable plaques differs in STEMI and NSTEMI and affects their outcomes is unknown.

Methods: In PROSPECT II (Providing Regional Observations to Study Predictors of Events in the Coronary Tree II), a multicenter, prospective natural history study, patients with recent myocardial infarction underwent 3-vessel coronary angiography with coregistered near-infrared spectroscopy and intravascular ultrasound after successful percutaneous coronary intervention of obstructive lesions from 2014 through 2017.

Circulating protein biomarkers and their association with vulnerable plaque characteristics - a PROSPECT II substudy.

Background: In the PROSPECT-II study, near infrared spectroscopy (NIRS) and intravascular ultrasound (IVUS) was used to characterize atherosclerotic plaques in the coronary arteries. NIRS-derived lipid core burden index (LCBI) and IVUS-derived plaque burden (PB) were able to identify plaques strongly associated with adverse cardiovascular events.

Aim: Our aim was to identify biomarkers associated with LCBI or PB in the coronary arteries.

Associations between physical activity and CVD-related metabolomic and proteomic biomarkers.

Aim: Habitual physical activity (PA) affects metabolism and homeostasis in various tissues and organs. However, detailed knowledge of associations between PA and cardiovascular disease (CVD) risk markers is limited. We sought to identify associations between accelerometer-assessed PA classes and 183 proteomic and 154 metabolomic CVD-related biomarkers.

Lack of atrial branch perfusion during acute ischemia is not associated with new-onset atrial fibrillation during STEMI.

Background And Aim: Atrial fibrillation (AF) often complicates ST-elevation myocardial infarction (STEMI). Atrial ischemia due to non-perfused atrial branches may contribute to its underlying mechanisms. We aimed to assess the association between atrial branches perfusion during STEMI and AF occurrence during and after STEMI.

A lumped parameter model of the coronary circulation incorporating time-varying resistance, intramyocardial pressure and vascular compliance.

Conventional lumped parameter models (LPMs) simulate coronary flow incorporating intramyocardial pressure and vascular compliance, but assuming constant resistance despite its dynamic changes during myocardial contraction. We developed a coronary LPM incorporating time-varying resistance, intramyocardial pressure and vascular compliance to simulate phasic flow, critically evaluating key contributing factors. A closed-loop LPM with coronary tree was constructed.

Lipoprotein(a), Cholesterol, Triglyceride Levels, and Vulnerable Coronary Plaques: A PROSPECT II Substudy.

Background: Although lipoprotein(a) (Lp[a]) has been associated with acute myocardial infarction (MI), the relationship between Lp(a) and the presence of high-risk "vulnerable" coronary plaques has not been studied.

Objectives: The aim of this study was to investigate whether specific lipoproteins are associated with pancoronary plaque volume and lipid deposition vs the development of non-flow-limiting high-risk vulnerable plaques.

Methods: In PROSPECT (Providing Regional Observations to Study Predictors of Events in the Coronary Tree) II, 3-vessel coronary artery imaging was performed with a combined near-infrared spectroscopy and intravascular ultrasound catheter after treatment of all flow-limiting lesions in patients with recent MI.

Trends in Risk Factors Among Young Patients with Acute Myocardial Infarction: A Nationwide Cohort Study.

Background: Acute myocardial infarction (AMI) is associated with significant loss-of-life expectancy, particularly among younger females. Addressing risk factors is crucial for optimizing prevention strategies.

Objectives: To describe the trends of risk factors and clinical outcomes, in a nationwide cohort of young AMI patients stratified by sex.

[Use of cardiovascular registries in regulatory pathways: perspectives from the EU-MDR Cardiovascular Collaboratory].

On May 26, 2021, the European Medical Device Regulation (EU-MDR) entered into effect resulting in a major shift in the requirements for assessment of medical devices in Europe. The EU-MDR Cardiovascular Collaboratory (EU-MCVC) was founded to contribute to the development of faster, more efficient, and more effective pathways for innovation of cardiac medical devices. A registry is an organized system that collects uniform data and evaluates specified outcomes in a population defined by a disease, condition, or exposure.

Prevalence of microspirometry-detected chronic obstructive pulmonary disease in two European cohorts of patients hospitalised for acute myocardial infarction: a cross-sectional study.

Objectives: To establish the prevalence of clinically significant chronic obstructive pulmonary disease (COPD) and relevant characteristics in individuals with a significant smoking history who are hospitalised for acute myocardial infarction (MI).

Design: Cross-sectional study.

Setting: Hospital inpatients at 8 European centres (7 in Sweden, 1 in the UK).

Practice patterns and percutaneous coronary intervention outcomes: a comparison between Sweden and the US.

Aims: Comparisons of international practice patterns and their impact on percutaneous coronary intervention (PCI) outcomes are lacking. We compared temporal PCI trends between Sweden and a large university hospital system in the US.

Methods And Results: Data within the Swedish Coronary Angiography and Angioplasty Registry (SCAAR) and the University of California San Diego Health internal National Cardiovascular Data Registry (NCDR) CathPCI Registry were used to identify patients who underwent PCI from 2007 to 2021.

Data quality assessment in the SWEDEHEART registry: Insights from serial audits on completeness and accuracy.

Background: Registry data used to monitor clinical care need to be reliable, and the process for assuring data quality transparent. Here the auditing process of the Swedish quality registry for cardiac disease, SWEDEHEART, is described.

Methods: SWEDEHEART audits have been performed at 4 time-points in 2011 to 2018, with data quality audited in the 3 largest subregistries covering acute coronary syndromes (ACS), percutaneous coronary interventions (PCI), and cardiac rehabilitation (CR).

Drug-coated balloons versus drug-eluting stents for small non-complex de novo coronary artery lesions: A segment-level propensity score matched analysis from SCAAR.

Background: The REC-CAGEFREE trial showed that drug-coated balloons (DCB) did not achieve non-inferiority in the treatment of non-complex de novo lesion compared to a strategy of drug-eluting stents (DES). However, a prespecified subgroup analysis of arteries sized <3.0 mm revealed no difference in the device-oriented outcome compared to DES.

Relationships of hsCRP to High-Risk Vulnerable Plaque After NSTEMI: Insights From the PROSPECT II Trial.

Background: Inflammation is a driver of atherosclerosis and susceptibility to cardiovascular events.

Objectives: The authors sought to evaluate whether high-sensitivity C-reactive protein (hsCRP) levels are associated with the prevalence of high-risk coronary plaques in patients with non-ST-segment elevation myocardial infarction (NSTEMI).

Methods: PROSPECT (Providing Regional Observations to Study Predictors of Events in the Coronary Tree) II was a multicenter, prospective study enrolling patients with recent myocardial infarction.

Myocardial infarction in ANCA-associated vasculitis: a population-based cohort study.

Objectives: To determine the incidence rate (IR) and predictors of myocardial infarction (MI) in patients with antineutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis (AAV) as well as to estimate the IR ratio (IRR) of MI in AAV versus the background population.

Methods: 325 patients diagnosed with AAV 1997-2016 in Skåne, Sweden were included. Data were collected from the time of AAV diagnosis, and each patient was grouped with 10 age-matched and sex-matched reference subjects from the background population.

The DNA repair factor ku80 binds and activates the adhesion receptor ELTD1/ADGRL4.

We investigated the mRNA expression of G protein-coupled receptors (GPCRs) in cells from four human vascular beds: umbilical vein (HUVEC), microvasculature (MVEC), aorta (HAEC), and coronary artery (CAEC). Our study revealed that the orphan receptor ELTD1 (ADGRL4) was the most abundantly expressed GPCR mRNA in all four EC types. When recombinantly expressed in U87 cells, ELTD1 receptors activated canonical GPCR pathways, particularly the Gq pathway.

Cangrelor During Percutaneous Coronary Intervention in Patients With Cardiogenic Shock or Cardiac Arrest.

Background: Little is known regarding treatment with cangrelor during percutaneous coronary intervention (PCI) in patients with myocardial infarction complicated by cardiogenic shock or cardiac arrest.

Objectives: The aim of this study was to investigate the effects of such cangrelor treatment during PCI in patients with myocardial infarction complicated by cardiogenic shock or cardiac arrest.

Methods: The study population included patients undergoing PCI (2016-2022) for myocardial infarction with cardiogenic shock or cardiac arrest from SCAAR (Swedish Coronary Angiography and Angioplasty Registry).

A genome-wide association study of imaging-defined atherosclerosis.

Imaging-defined atherosclerosis represents an intermediate phenotype of atherosclerotic cardiovascular disease (ASCVD). Genome-wide association studies (GWAS) on directly measured coronary plaques using coronary computed tomography angiography (CCTA) are scarce. In the so far largest population-based cohort with CCTA data, we performed a GWAS on coronary plaque burden as determined by the segment involvement score (SIS) in 24,811 European individuals.

Invasive Coronary Angiography has Limited Diagnostic Accuracy for Detecting Reduction of Myocardial Perfusion Assessed by Cardiac Magnetic Resonance.

The relationship between degree of coronary artery stenosis and its effect on myocardial perfusion is complex and constitutes a clinical challenge. The aim of this study was to assess diagnostic accuracy of visual assessment of invasive coronary angiography (ICA) for detecting reduced myocardial perfusion determined by quantitative first-pass perfusion (qFPP) cardiac magnetic resonance (CMR) in patients with suspected or established chronic coronary syndrome (CCS). Forty-nine patients with suspected or established CCS were included from the elective ICA list in this prospective, observational study and underwent qFPP CMR prior to ICA.